Abstract
The upper limit of “normal” blood Pb level (BPb; in μg/100 ml whole blood) in urban children is undetermined, although values ≥ 40 are officially considered abnormal. This study sought to determine the BPb at which the earliest metabolic effects of Pb become apparent and whether measurements of Free Erythrocyte Porphyrins (FEP; in ug/g Hgb) are a more sensitive indication of increased body burden of Pb.
The correlation between FEP and BPb was analyzed in 1892 samples of blood submitted for BPb to the NY City Dept. of Health. In the 640 samples with BPb 0-30 there was no correlation; mean FEP was 2.4, and 8% had positive FEP test (FEP+ = FEP > 5.5), presumably due to Fe deficiency. As BPb reached 30, FEP levels increased exponentially. In the 297 samples with BPb 30-39 mean FEP was 3.5, and 16% were FEP+. The FEP level rose at the same fast exponential rate up to BPb 60, where mean FEP was 17 and 100% of the samples were FEP+. At BPb > 60, FEP rose further at a slower rate.
EDTA provocation was performed in 31 FEP+ children with BPb 30-54. Abnormal urine Pb was found in 7/8 children with BPb 30-39; in 7/8 with BPb 40-44; in 8/9 with BPb 45-49 and in 6/6 with BPb 50-54.
These data indicate that FEP levels increase significantly much before BPb reaches the “official” value of 40 and detect increased body burden of Pb with greater sensitivity than BPb.
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Piomelli, S., Young, P., Brickman, A. et al. THE DETECTION OF SUBCLINICAL Pb INTOXICATION IN URBAN CHILDREN. Pediatr Res 8, 345 (1974). https://doi.org/10.1203/00006450-197404000-00031
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DOI: https://doi.org/10.1203/00006450-197404000-00031
